IMT: The IMT was performed by an exercise tool (Threshold IMT, Respironics, USA). The IMT was administered to the patients at 30% of the measured maximal inspiratory pressure (MIP), seven days a week, with 15 min twice a day for a total of six weeks. The patients were instructed to visit the physiotherapy department once a week. The measurements of the patients were repeated, new training loads were adjusted, and IMT was given under supervision. All patients used a nose- clips during training and were told to take five deep breaths to maintain diaphragmatic breathing with the device and, then, they were instructed to take the device out and rest for 5–10 s.